Evaluation of chemotherapy-induced peripheral neuropathy using current perception threshold and clinical evaluations

Abstract

Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is increasing with introduction of new and combination cancer pharmacotherapies. This study evaluated associations between clinical and self-report measurements and current perception threshold (CPT), a neuroselective measure of sensory nerve function that may detect asymptomatic CIPN damage. Methods Data for this secondary analysis were from a prospective, observational study using CPT to evaluate CIPN. Bivariate mixed models, accounting for the intra-class correlation between repeated patient assessments, were used to assess the relationship between CPT at each frequency (5Hz, 250Hz and 2000 Hz) and each subjective measure (Neuropathic Pain Scale, FACT-GOGntx) and objective measurement (quantitative sensory testing, deep tendon reflexes, grip strength). Results A total of 29 chemotherapy-naïve subjects with various cancer types had a mean age of 56.7 (SD 10.4); 9 subjects developed CIPN grade > 1 using NCI CTC-AE criteria. Cold detection thresholds were inversely associated with CPT 5 [b(95% CI) =−2.5(−4.5, −0.5)] and CPT 2000 [−7.5(−11.8, −3.3)] frequencies. FACT GOG-ntx quality of life (QoL) scale and neurotoxicity and function subscales were inversely associated with CPT 2000 [−1.8 (−3.5, −0.05), −2.2 (−4.2, −0.2), and −5.4(−9.8, −0.9), respectively], indicating worsening QoL, impairment, and function as hypoesthesia increases. Conclusions CPT 2000 may identify impending worsening of patient-reported outcomes, such as QoL.

Chemotherapy-Induced Neuropathy in Cancer Survivors

“…In the only study identified that compared patients who were CTX naïve (n=20), to patients who received CTX (n=9), 104 the mean grip strengths were 33.5 kg (±8.5) and 30.1 kg (±11.4), respectively. For both groups of patients in our study, the mean grip strengths were lower which may be related to differences in the mean age of the patients and the fact that survivors without CIN did receive CTX.…”

Oxaliplatin-Induced Peripheral Neuropathy and Identification of Unique Severity Groups in Colorectal Cancer

“…DTRs are a measure of the sensorimotor system, and reduced response is an indication of sensory neuropathy in the setting of OIPN. Reduced DTRs have been shown to occur in association with hypoesthesia using current perception threshold in the setting of chemotherapy-induced peripheral neuropathy 32 . We have also reported reduced vibration perception in combination with reduced DTRs using TNSc © , where DTRs were the most sensitive component of the neurological examination in chemotherapy-induced peripheral neuropathy 33 .…”

Quality of life and resilience related to chemotherapy-induced peripheral neuropathy in patients post treatment with platinums and taxanes

“…Scores for the sensory, motor and autonomic scales indicated low levels of symptomatology/problems for the study participants. Elsewhere, it is reported that reduced feelings of touch and sensation associated with CIPN, reflected patients' worsening quality of life (Griffith et al, 2013).…”